Regaining Control: Tips for Dealing with Urge Urinary Incontinence

Incontinence; let’s talk about it.

It’s something that has become so “normalized” in mom culture, but leaking urine isn’t normal! We know that it creates not only impacts women physically, but there are many emotional aspects that come with incontinence as well including the feelings of shame, embarrassment and more.

There are two main types of incontinence - stress urinary incontinence, which you can read more about here, or urgency urinary incontinence.

Urinary incontinence is involuntary loss of urine that occurs with a strong desire to urinate. Pelvic floor therapists everywhere will tell you this condition is infamous amoung teachers, nurses, and women who have professions where they are not free to go to the bathroom as they please.

Common symptoms or triggers that might signal you have urgency incontinence include:

  • Feeling like you need to go as soon as you put your key in the door upon arriving home.

  • The sound of running water makes you leak.

  • Cold ambient temperature gives you the urge to go.

  • You leak on the way to the toilet/while pulling you pants down.

  • Feeling like it is often a “rush” to get to the toilet.

  • A change of position causes you to leak (such as going from standing to sitting or vice versa).

Urinary urgency or urge incontinence happens when the bladder contracts when it is not supposed to, resulting in subsequent leakage of urine. This can be due to medical reasons, but more often than not it is caused by poor bladder habits and weak pelvic floor muscles.

The good news? There are ways you can retrain your bladder!

We’ve put together our best tips on how you can work to fix your urgency incontinence.

Bladder Diary

A bladder diary is a helpful tool that can help you recognize your bladder habits. It works to show your daily habits - and whether they are good, or perhaps need some adjustment. The bladder is a very habitual muscle/organ and it can be trained! We have created a bladder diary for you to use below - enter your information and it will be sent directly to your inbox!

Prevention

To decrease the urge to urinate, you can work on performing pelvic floor contractions (Kegels) to cause inhibition of the bladder. When we successfully inhibit the bladder it stops the bladder from spasming. The spasm is ultimately what creates the urgency feeling to pee. Urge control strategies are often more successful if you are able to SIT, but this can be performed standing. Experiment if holds of 1-2 seconds or longer holds of 3-8 seconds work to calm your bladder.

Urge Control Strategies

When you experience a strong urge to urinate, stop whatever you are doing. Don’t rush to the nearest bathroom right away, rather stop where you are, relax (sit down if possible) and perform the technique outlined. The goal is to perform the steps below and CALM THE URGE before rushing to the bathroom. We coach women but this is not a “contract and HOLD” but rather a slow, cyclical contract/relax cycle.

  1. Perform a series of pelvic floor contractions called quick flicks, by activating your pelvic floor and releasing it. Hold for one count, release for one count. If this does not work for you attempt to hold a pelvic floor contraction until you feel a decrease in the urge.

  2. Once the urge subsides, relax your muscles. Take a deep breath (diaphragmatic breath) and proceed to the restroom.

  3. If the urge returns, repeat the steps above. This may require you to stop walking on your way to the bathroom.

  4. You can also try to stand outside the door of the restroom and repeat technique to calm down the urge.

  5. Teach your bladder who is boss! Once you make it to the bathroom, slowly pull your pants down. Sit on the toilet and don’t allow yourself to pee as soon as your bottom hits the toilet. Try not sitting on the toilet until the strong urge subsides.

Tips for Bladder Re-training to Treat Urge Incontinence

  1. Train your naughty bladder. Normal urination frequency is every 2-5 hours or 4-7 times/day. Don’t go to the bathroom before you leave the house just because you are leaving. Don’t go right when you get home just because you get home. Avoid going as soon as you get somewhere if this is habit for you.

  2. Notice what your triggers are (i.e. pulling into your driveway and you suddenly have to pee, putting your key in the door and you suddenly have to pee). Once you realize what your trigger is, do not go to the bathroom right away and perform the steps listed above.

  3. Sit on the toilet with relaxed upright posture (no hovering!)

  4. Do not push or strain while urinating. Use diaphragmatic breathing on the toilet and put your phone down.

  5. Stay hydrated.

  6. Avoid or limit bladder irritants- i.e. caffeine, alcohol, citrus and tomato based products.

  7. Get your bowels on board too. Avoid constipation.

  8. Length of urination should be at least 8-10 seconds.

  9. Never try to stop the flow once you are start peeing.

  10. Try double voiding to make sure you are emptying your bladder:

    Steps to Double Voiding:

    • Sit, relax, breathe, and empty your bladder as completely as possible

    • With your feet on the floor, exhale and lean forward as much as possible, so much so that your butt starts to come off the toilet seat.  

    • Stand up

    • Sit back down, relax again, and see if any additional urine can be voided

    • If a lean forward does not produce any additional urine, stand up completely and then return to sitting on the toilet and see if that makes a difference

ALSO see our post HERE on overall bladder health!

Need more help?

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